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Medicare Supplement Prequalification Questions Below

Guaranteed Issue Qualifications Questionaire

Open Enrollment / Guaranteed Issue Questions 
If you lost or are losing other health insurance coverage and received a notice from your prior insurer saying you were eligible for Guaranteed Issue of a Medicare Supplement insurance policy or that you had certain rights to buy such a policy, you may be guaranteed acceptance in one or more of our Medicare Supplement plans.

PLEASE ANSWER ALL QUESTIONS: To the best of your knowledge:
2. Did you turn age 65 in the last six (6) months? *This question is required.
3. Did you Enroll in Medicare Part B in the last (6) months? *This question is required.
4. Are you covered for medical assistance through the state Medicaid program?  *This question is required.
5. Have you had coverage from an Medicare plan other than original Medicare within the past 63 days (for example, a Medicare Advantage plan or a Medicare HMO or PPO) *This question is required.
6. Do you have another Medicare Supplement policy in force? *This question is required.
7. Have you had coverage under any other health insurance within the past 63 days (for example, an employer, union, or individual plan)? *This question is required.
8. Do you now have Medicare Parts A and B? *This question is required.
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